Profiles

 Jessica Storbjörk

Jessica Storbjörk

Associate professor

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Works at Department of Public Health Sciences
Telephone 08-16 14 68
Email jessica.storbjork@su.se
Visiting address Sveavägen 160, Sveaplan
Room 333
Postal address Institutionen för folkhälsovetenskap 106 91 Stockholm

About me

Jessica Storbjörk is an Associate Professor of sociology, Senior Lecturer at the Department of Public Health Sciences, and Director of the Centre for Social Research on Alcohol and Drugs (SoRAD). She performs research into alcohol and other drugs and addiction with special emphasis on addiction treatment and treatment systems in Sweden as well as internationally.

Storbjörk's more recent research projects have studied citizens' rights and obligations in the welfare sector, national treatment policy, organizational changes in the Swedish addiction treatment system, international comparisons regarding treatment systems and service users, and the extent to which and how service users are involved in treatment in their own case. At the moment she is focussing on the organization and government of addiction treatment and how such factors impact on the daily practice in the social services, health care system and in othher for-profit and not-for-profit organizations. The work is conducted within the frame of a study on benefits, tensions and inconsistencies following the implementation of New Public Management and other organizational tendencies and steering principles, e.g., public procurement.

Her previous research more specifically targeted service users' own experiences in studies of how people with alcohol and drug problems enter treatment, social control, compulsory care, homelessness, social marginalization/exclusion, gender differences, substance related mortality, treatment outcomes, and service users' reasons for changed substance use.

As concerns different expert assignments, we can mention that Storbjörk is a member of the scientific board of the National Board of Institutional Care (SiS); she is a member of the scientific advisory board of the journal Nordic Studies on Alcohol and Drugs (JSAD); she acts as Assistant Field Editor of the Journal of Studies on Alcohol and Drugs (NAD); and she has participated in various expert groups on addiction and gambling at the National Board of Health and Welfare. She contributed to the launch of the national research network Alcohol and Drug Research within Social Sciences (Sonad) and served as its coordinator 2010-2017, and again as of 2019. She has spent time as a guest researcher at research centers in Australia, Finland, and the USA.

Teaching

Jessica Storbjörk participates in the creation of new courses and bachelor's and master's programs at the Department of Public Health Sciences. She is currently teaching a course on addictive substances and behaviors (basic level) and is teaching four advanced level courses on welfare states and policies, and qualitative research methods.

She has previously has taught at basic, advanced and PhD-level social science courses on alcohol, illicit drugs, and addiction; qualitative and quantitative research methods; and gender. She has taught at departments within the Faculty of Social Sciences at Stockholm University, and at Uppsala University, the Karolinska institutet, and at courses arranged by the Nordic council for Alcohol and Drug Research (NAD).

Research

Ongoing research projects

Benefits, tensions and inconsistencies in the health and welfare system: The case of New Public Management in Swedish substance abuse treatment (2015-2017, Riksbankens Jubileumsfond/The Swedish Foundation for Humanities and Social Sciences). Principal investigator (PI).

Alcohol and other drug treatment funding, purchasing and workforce: empirical analyses to inform policy (2017-2019, by NHMRC Australia, PI Ritter). Associate investigator.

Previous projects

Network: Alcohol and Drug Research Network within Social Sciences (Sonad) (2004-ongoing, Forte). PI 2010-2017.

The position of the service users in Swedish addiction treatment – a study of service user involvement in practice (2013-2017, Forte). PI.

A reformed substance abuse treatment system? Actors, arguments and power (2012-2013, senior lecturer position). PI.

Rights and obligations in the welfare state: the voices of policy-makers, professional groups and socially included and excluded citizens (2010-2011, Forte). PI.

Equal problems in an equal treatment system? Similarities and differences between women and men in treatment: consumption, problems and treatment experiences (2009-2010, part study of the research program Women’s health, PI Törrönen, FAS/Forte). PI.

How, when and for whom is compulsory treatment used? (2008, the National Board of Institutional Care (SiS), PI Palm). Research scientist.

Treatment outcome among alcohol and drug users: Outcome in relation to pressures to seek treatment and level of decentralization of the treatment system (2008, SRA – the Alcohol Research Council of the Swedish Alcohol Retailing Monopoly, PI Stenius). Research scientist.

A comparative study of treatment systems, treatment interventions and long-term outcome among alcohol and drug users in Stockholm County and northern California (2007-2009, FAS/Forte, the social welfare administration of Stockholm, the County administrative board of Stockholm, and SRA), PI Stenius). Research scientist.

Evaluation of “Vårdkedjeprojektet” – an after care effort/trial in the compulsory treatment system (2005-2007, SiS, PI Stenius). Research assistant.

Guests of a voluntary organization: their networks, problems, needs and resources (2005, the Swedish National Drug Policy Coordinator, PI Room). Study director & PhD student.

ROSE-EU (Risk Opiate Addicts Study), Management of high risk opiate addicts in Europe (2002-2004, 5th Framework of the EU, multi-cite study, PI Krausz, PI for Sweden Romelsjö). Research assistant & PhD student.

TREAT-2000, Treatment Systems Research on European Addiction Treatment (2000-2003, 4th Framework of the EU, multi-cite study, PI Gastpar, PI for Sweden Room). Assistant study director & PhD student.

Women and men in Swedish alcohol and drug treatment (2000-2004, the Swedish Ministry of Social Affairs and Health, PI Room). Assistant study director & PhD student.

Publications

A selection from Stockholm University publication database
  • 2020. Jessica Storbjörk. SUCHT 66 (2), 93-103

    Aims: The study examined how substance use treatment professionals managed problems and tensions in their work, and explored if the strategies varied by organisational features related to New Public Management (NPM). Methods: A total of 69 semi-structured interviews(2017–2018) with treatment staff in nine sampled local/regional areas formed the basis for constructing a web survey administered to staff across Sweden in 2019 (n=606). The means showed how often the different strategies were used. Regression analyses examined organisationaldifferences, and central strategies were illustrated by the interview study. Results: Treatment professionals in general reported satisfactory freedom in their work. Staff in more NPM-like organisations were less likely to report autonomy and more inclined to report conflicting demands.When conflicts emerged, the staff used both passive strategies indicating adaptation or resignation, and active strategies including boundary spanning, protest, and liberty-taking. Some challenging strategies such as looking for other jobs or reporting one thing but doing anotherwere more common in more NPM-like organisations. The opposite was found for customer orientation. Conclusions: While NPM features on customer orientation and steering methods appeared to create fewer problems, more NPM-like organisations appeared to be less favourableoverall and should be applied with caution.

  • 2019. Kerstin Stenius, Jessica Storbjörk. Nordic Studies on Alcohol and Drugs, 1-26

    Aim: In increasingly market-oriented welfare regimes, public procurement is one of the most important instruments of influencing who produces which services. This article analyses recent procurement regulations in four Nordic countries from the point of view of addiction treatment. The implementation of public procurement in this field can be viewed as a domain struggle between the market logic and the welfare logic. By comparing the revision of the regulations after the 2014 EU directives in Denmark, Finland, Norway, and Sweden, we identify factors affecting the protection of a welfare logic in procurement. We discuss the possible effects of different procurement regulations for population welfare and health. Data and theoretical perspective: The study is based on the recently revised procurement laws in the four countries, and adherent guidelines. The analysis is inspired by institutional logics, looking at patterns of practices, interests, actors, and procurement as rules for practices. Results: Procurement regulations are today markedly different in the four countries. The protection of welfare and public health aspects in procurement – strongest in Norway – is not solely dependent on party political support. Existing service providers and established steering practices play a crucial role.  Conclusion: In a situation where market steering has become an established practice and private providers are strongly present, it can be difficult to introduce strong requirements for protection of welfare and population health in procurement of social services.

  • 2018. Jessica Storbjörk, Kerstin Stenius. Social Policy & Administration

    Given its traditions of universal welfarism and social democracy, Sweden had already scored unexpectedly high on New Public Management by the 1980s. Health and welfare services remain primarily tax‐funded, but the production of care is increasingly transferred to a competitive quasi-market. To what extent can this development be understood in terms of right‐wing governments, and to what extent in terms of other, socioeconomic and pragmatic factors? We examined this question through official statistics on providers of institutional addiction care since 1976, and through the total expenditure and purchases by local‐level municipal social services of interventions for substance users in Sweden in 1999, 2004, 2009, and 2014. We have analyzed the distribution across publicand private providers within the addiction treatment system, and whether national developments and local differences across the 290 municipalities—which bear the major treatment responsibility—can be understood in terms of local‐level political majority, population size, and local wealth. The share of purchased services has remained stable, but the treatment system shows increasing financial turnover and an increasing share of for‐profit providers among producers of purchased care, especially in outpatient treatment. While venture capital enterprises emerged as a new actor, non‐governmental organizations lost out in importance. Bourgeois government correlated with larger shares of purchasing and purchases from for‐profit providers. However, purchasing on a market dominated by for‐profit providers has also become the “newnormal”, regardless of ideology, and recent years have shown a reversed effect of left‐wing municipalities purchasing more services than right‐wing governments. Pragmatic reasons also influence local‐level purchasing.

  • 2019. Jessica Storbjörk, Kerstin Stenius. Journal of Studies on Alcohol and Drugs (s18), 31-39

    Objective: Researchers generally assume that addiction treatment systems can be viewed as entities and planned with the citizens’ best interests in mind. We argue that another steering principle, the market logic, has permeated many Western World treatment systems but is neglected in research. We demonstrate how it may affect system-level planning, service provision, and the service users.

    Method: Wedraw on an ongoing Swedish study, with some Nordic references, using several data sources: (1) public statistics on treatment expenditures and purchases; (2) interviews with service users (n = 36) and their service providers (n = 23) on different market features; (3) an observation of a large public procurement process concluding framework agreements based on competitive tendering; (4) interviews with officials involved with steering of the system and procurement (n = 16); (5) a workshop on procurement in the Nordic countries (n = 11 participants); and (6)77 interviews with professionals, managers, and elected representatives.

    Results: We outline seven propositions that call for further research attention: public procurement, as regulated in the European Union, is not suitable for addiction treatment; marketization challenges democracy, equity, needs assessment, and treatment planning; marketization causes new accountability problems and idle monitoring; marketization causes fragmentation and obstructs coordination and continuity of care; marketization causes unification of services and favors big bureaucratically sophisticated providers; treatment professionals’ values are downplayed when a mistrust-based market logic replaces a trust- and needs-based logic; and marketization marginalizes treatment professionals and service users by limiting discretion.

    Conclusions: Findings point toward the importance of acknowledging and mitigating market principles in treatment systems to safeguard needs assessments and planning that serve the interests of the service users and the public. (J. Stud. Alcohol Drugs, Supplement 18, 31–39, 2019)

  • 2018. Jessica Storbjörk. Drug and Alcohol Review

    Treatment providers demonstrate a quite strong support for a disease model of addiction, particularly so in the United States. However, conceptions vary and the problems may be perceived as primarily a disease, moral or social problems, or a combination of these (Barnett et al. in press). This commentary discusses the ongoing and dynamic process of defining addiction problems and notes that non-medical perspectives often appear in the shadow of and tend to oppose the disease model that stands quite inviolable – i.e., like the One Ring to rule them all by citing The Lord of the Rings. Recent changes in the Swedish Addiction treatment system, well known for its social perspective on the nature and handling of addiction problems, are highlighted to demonstrate that the world may be changing, or not. It is argued that there cannot be just one model. 

  • 2018. Jessica Storbjörk, Eva Samuelsson. Socialtjänstmarknaden, 85-115

    Kapitlet behandlar brukarinflytande inom missbruks- och beroendevården och diskuterar den potentiella konflikten mellan denna företeelse och New Public Management (NPM). Kapitlet diskuterar hur företeelser som ofta förknippas med NPM (t.ex. upphandling och ramavtal, valfrihet, prestationsbaserade ersättningssystem) inverkar på handlingsutrymme och vårdbeslut utifrån personalens och brukarnas utsagor, liksom hur klienter och patienter ser på sina möjlighetertill inflytande i en NPM-inspirerad vård.

  • 2017. Jessica Storbjörk, Joshua B. B. Garfield, Andrew Larner. Substance Use & Misuse 52 (4), 439-450

    Background: Clinical studies of alcohol and drug treatment outcomes frequently apply participant eligibility criteria (EC), which may exclude real-world treatment seekers, impairing the representativeness of studied samples. Some research exists on the impact of EC on alcohol treatment seekers. Little is known about drug treatment and country differences. Objectives: We tested and compared the degree to which commonly used EC exclude real-world treatment seekers with problem alcohol and drug use in Sweden and Australia, and compared the impact of EC on outcomes. Methods: Two large naturalistic and comparative service user samples were used. Respondents were recruited in Stockholm County (n = 1,865; data collection 2000–2002), and Victoria and Western Australia (n = 796; in 2012–2013). Follow-up interviews were conducted after 1 year. Cross-tabulations, Chi-square (χ2) tests and logistic regressions were used. Results: Percentages of the samples excluded by individual EC ranged from 5% (lack of education/literacy) to 70% (social instability) among Swedish alcohol cases and from 2% (low alcohol problem severity) to 69% (psychiatric medication) among Australian counterparts; and from 2% (age 60+ years) to 82% (social instability) among Swedish drug cases and from 1% (age 60+ years) to 67% (psychiatric medication) among Australian counterparts. Country differences and differences across substances appeared independent of country effect. Co-morbid psychiatric medication, noncompliance, poly drug use, and low education EC caused positive 1-year outcome bias; whereas female sex and old age introduced negative outcome bias. Conclusions/Importance: Commonly used EC exclude large proportions of treatment seekers. This may impair generalizability of clinical research, and the effects of many EC differ by country and drug type.

  • 2016. Harald Klingemann, Storbjörk Jessica. The SAGE Handbook of Drug & Alcohol Studies, 260-286

    Following some introductory notes on addiction treatment management as a specific case of societies’ response to deviant behaviours and social problems, an overview of the theoretical classifications and dimensions of addiction treatment systems is presented. The anti-thesis to these ideal-type system concepts is represented by the market New Public Management model oriented towards outcomes, regardless of the nature and organizational features of addiction interventions. As complementary to these general theoretical orientations, this serves as a review of specific issues concerning ‘a combined and integrated approach versus a specialized and segregated approach’, ‘the quest for the best treatment modalities’, ‘empirical and ethical aspects of coercion in treatment’ and ‘the relevance of user needs and orientation’. The empirical part begins by highlighting the ‘expert survey‘, ‘case study‘ and dynamic diffusion‘  approaches as treatment mapping strategies and informs on some key results, e.g. from the WHO Atlas –SU survey and the International Studies in the Development of Alcohol and Drug Treatment Systems. Results from an expert survey from fourteen countries conducted in 2014 illustrate the role of general political changes, efforts to control treatment systems, integration dynamics, the treatment gap and changing outcome criteria with concrete current examples. The conclusions point to the relative importance of professional addiction interventions drawing upon self-change research and the role of alternative lay help and outline factors in impeding system changes.

Show all publications by Jessica Storbjörk at Stockholm University

Last updated: June 29, 2020

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